Get Commonwealth Care Alliance Edi Questionnaire Edi Questionnaire - Commonwealthcarealliance

This guide provides a clear and supportive approach to completing the Commonwealth Care Alliance EDI Questionnaire. By following these step-by-step instructions, users can efficiently fill out the form and ensure accurate submissions.

Follow the steps to successfully complete the EDI Questionnaire.

1. Press the ‘Get Form’ button to access the EDI Questionnaire and open it in your preferred document editor.
2. Complete the Provider/Group Information section. Fill in your name, mailing address, tax ID number, group/individual NPI, phone number, contact person, email address, and fax number. Additionally, check the appropriate box that represents your submission type, whether it is Clearinghouse Submission, 837 Direct Batch Submissions, Single Claim Submissions, Web Portal Access, or New Provider Set-Up.
3. If you indicated that your office will be submitting claims through a Clearinghouse, answer the question regarding the Clearinghouse submission and provide the name of the Clearinghouse you will be using.
4. For 837 Direct Batch Submissions, answer whether you will submit claims in the 837 format and select the type of transaction for your submission (professional and/or institutional claims). Remember that batches cannot exceed 5,000 claims, and be sure to note that testing is required.
5. Indicate your interest in Single Claim Submissions if applicable. Note that a training session will be required to effectively navigate the secured web portal for this option.
6. In the EZNET web portal user access section, list the names, phone numbers, and email addresses of individuals who will require access along with their corresponding user privileges.
7. Move to the New Vendor/Provider Set-Up section. Depending on your provider type, ensure to provide all necessary documents including your W9 Form, trading partner agreements, and EFT/ERA forms. Be accurate in checking the appropriate options based on your provider status.
8. Once you have completed the form, review all entries for accuracy and clarity. Finally, save your changes, and choose to download, print, or share the completed questionnaire as needed.

Complete the Commonwealth Care Alliance EDI Questionnaire online to ensure a smooth submission process.